Pregnancy outcomes favourable for women with idiopathic noncirrhotic portal hypertension
Despite condition-related complications, pregnancy in women with idiopathic noncirrhotic portal hypertension (INCPH) results in favourable foetal outcomes in a majority of cases reaching 20 weeks of gestation, reports a new study.
Researchers retrospectively reviewed the medical charts of 16 women with INCPH who had ≥1 pregnancy during the follow-up period for their liver disease. A total of 24 pregnancies were reported within a median of 24 months after INCPH diagnosis. All patients had serum bilirubin levels <2 mg/dL, and 75 percent had oesophageal varices upon diagnosis.
Over the median gestation duration of 35 weeks, one ectopic pregnancy, four miscarriages and one terminated pregnancy for medical reasons were reported. Eighteen pregnancies reached 20 weeks of gestation, of which one was born very preterm at 27 weeks. Eight were moderately preterm, while nine were term deliveries.
Two infant deaths were reported, one due to infectious meningitis and one due to unknown causes. Another infant had bradycardia during labour but was without sequelae, while another was born small for gestational age. All the other infants were born healthy and with appropriate birthweight.
Six portal hypertension-related complications were documented, including one case of worsening portopulmonary hypertension, three cases of worsening ascites and two cases of variceal bleedings.
No other liver-related complications were reported in the remaining 18 pregnancies. None of the participants developed liver failure or encephalopathy. All patients were asymptomatic at a median follow-up of 27 months after last delivery, and no maternal deaths occurred.